A precise reconstruction of the left atrium (LA), the pulmonary veins (PV) and the left
atrial appendage (LAA) is of critical importance in order to achieve efficient and safe
results in atrial fibrillation ablation. Currently the LA reconstruction methods are mainly
based on techniques as Fast Anatomical Mapping (FAM) and cardiac CT merging. FAM mapping
requires catheter manipulation by a skilled operator and it is time consuming. The raw
anatomy obtained with FAM requires also a post imaging refinement of the LA surfaces by
shaving of the image with sculpting tools before the initiation of the ablation and
throughout the procedure. A drawback of this approach is represented by the frequent lack of
accuracy in the definition of critical areas of the LA during the ablation as PV antrum, left
PVs-LAA appendage ridge, PV carinas. An alternative approach is based on the merging of the
FAM reconstruction to a CT scan of the left atrium acquired before the procedure (Carto
Merge). The advantage of this technique is a far better definition of the LA anatomy
including PV antrum, PV sizing, angle of insertion on the LA of the PV and the recognition of
PV anomalies (PV common os, separated branches, additional PVs). The drawbacks of these
approaches are mainly related to the exposure of the patients to contrast media during the
cardiac CTA and the additional costs of the CT scan to the entire budget of the procedure.
The CARTOSOUND® FAM algorithm is a model-based algorithm, developed using the Machine
Learning methodology, which reconstructs a 3D volume of the Left Atrium (LA) anatomies (LA
Body, Left Atrial Appendage - LAA, Left Inferior Pulmonary Vein - LIPV, Left Superior
Pulmonary Vein - LSPV, Right Superior Pulmonary Vein - RSPV, and Right Inferior Pulmonary
Vein - RIPV) based on a series of 2D ultrasound frames acquired from the Right Atrium - RA
(Fossa Ovalis) and the RVOT. In addition to the 3D volume reconstructed, the CARTOSOUND® FAM
algorithm generates 2D automatic contours that are overlaid on the corresponding 2D
ultrasound frames and provides auto segmentation of the Left Atrium (LA) anatomies. The
advantages of the CARTOSOUND FAM are related to the shortening of mapping required to achieve
an entire LA reconstruction and better resolution of the LA anatomy compared to FAM.
The aim of the present study is to compare the LA reconstruction obtained with CartoSound-FAM
software and The M-FAM software to the Carto Merge 3D reconstruction and FAM in consecutive
patients referred for AF ablation.